孕妇外周血胎儿有核红细胞数与胎儿及胎盘异常关系_医学论文.docVIP

孕妇外周血胎儿有核红细胞数与胎儿及胎盘异常关系_医学论文 孕妇外周血胎儿有核红细胞数与胎儿及胎盘异常关系_医学论文 作者：杨晓菊 徐金娥 赵金霞 杨宗利 刘晶 【摘要】 目的 探讨在胎盘和胎儿发生病理性变化时,母血中胎儿有核红细胞(FNRBC)数量的变化,为母血中FNRBC计数在无创性产前诊断中的应用提供理论基础和实验依据。方法 对110例8～40孕周的妇女(60例正常妊娠,30例病理妊娠,20例胎儿异常)外周血进行单密度梯度离心,瑞氏染色和细胞计数,分析母血中FNRBC数量在病理妊娠和胎儿异常时的变化及其与孕周的关系。对有胎儿异常可能的病例，孕早期(8～12周)自然流产者行绒毛细胞核型分析，孕中期(13～24周)及晚期(25周以上)取流产儿和新生儿血进行染色体分析。结果 正常妊娠时，母血中FNRBC平均数量为(10.20±8.11)×103/L，病理妊娠和胎儿异常时母血中FNRBC平均数量为(23.09±12.42)×103/L和(38.93±14.87)×103/L，病理妊娠组和胎儿异常组与正常妊娠组相比差异有显著性(F=25.927，q=4.236、10.674，0.01)。正常妊娠组和病理妊娠组母血中FNRBC数量与孕周呈正相关(r=0.491、 0.500,0.05)。而异常胎儿组母血中FNRBC数量与孕周无相关性(r=0.283，Pgt0.05)。结论 在胎儿和胎盘发生病理性改变时，母血中FNRBC数量较正常妊娠增加，同时母血中FNRBC数量随孕周增加而增加，母血中FNRBC计数对产前预测病理妊娠和胎儿异常的发生有辅助意义。 【关键词】 孕妇胎儿有核红细胞产前诊断 [ABSTRACT] Objective To investigate the changes of the counting of fetal nucleated red blood cells (FNRBC) and their relationship with pathology of fetus and placenta, and provide rationale and experiment evidence for the application of FNRBC in noninvasive prenatal diagnosis. Methods This study consisted of 110 women with 8-40 weeks of pregnancy (60 with normal pregnancy, 30 with pathopregnancy, and 20 with fetal disorder). Counting of FNRBC in the maternal blood and its relationship with gestational weeks, pathological gestation and abnormal fetus were evaluated by single density centrifugation and Wrights staining. For suspected cases, in early pregnancy (8-12 weeks), chorionicvilluscell karyotype analysis was done in those with spontaneous natural abortion in the midtrimester (13-24 weeks) and the late pregnancy (over 25 weeks), the abortus or newborn blood was collected for chromosome analysis. Results Of normal pregnacy, the average quantity of FNRBC in maternal blood was(10.20±8.11)×103/L of pathopregnancy and abnormal fetus, it was (23.09±12.42)×103/L and (38.93±14.87)×103/L, respectively. The differences of FNRBC count between normal pregnacy and both pathopregnacy and abnormal fetus were significant (F=25.927q=4.236,10.6740.01). The FNRBC count of pathoand norm